Provider Demographics
NPI:1467162404
Name:ERWIN-BURNS, CHELSEA NICHOLE (COTA)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:NICHOLE
Last Name:ERWIN-BURNS
Suffix:
Gender:
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 797
Mailing Address - Street 2:
Mailing Address - City:VALLIANT
Mailing Address - State:OK
Mailing Address - Zip Code:74764-0797
Mailing Address - Country:US
Mailing Address - Phone:580-448-2021
Mailing Address - Fax:580-448-0021
Practice Address - Street 1:3166 CLARKSVILLE ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-8015
Practice Address - Country:US
Practice Address - Phone:903-784-7702
Practice Address - Fax:903-784-7703
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX215870224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant